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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Social orientation of the marketing and its role in the competitive strategies
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     This research shed light on the relationship between the social orientation of the marketing (interests of the Organization ,the welfare of society, satisfaction the customer) strategies competitive dimensions of (cost leadership strategy, differentiation strategy, focus and strategy), As well as to to seek to achieve a number of knowledge and applied goals, and represented the field research problem extent of interesting researched the application of social orientation and interest in achieving competitive strategy and omission of this interest in the hotels the surveyed Organization, Based on this problem, and to clarify the relationshi

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Publication Date
Tue Mar 30 2021
Journal Name
College Of Islamic Sciences
The wisdom of establishing the right by testimony in jurisprudence and law
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Abstract

Islam has been concerned with preserving and maintaining rights, so the provisions in which it is preserved are legislated. Among that  is the testimony that made it a way to prove the truth and obliges its bearer to fulfill right in order to preserve the right and establish justice and prevent injustices by defying conflict, and tyranny .

And while acknowledging that divine absolute wisdom that is the cause and origin of legal rulings is sufficient, it is obligatory to abide by its provisions and imposes obedience, surrender, contentment and work in accordance with its controls.

However, the realization of the defects behind the legislation in a comprehensive way that realizes the dev

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Audit strategies and their role in the quality of the business audit
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Increased the need to promote the profession of auditing, and improving the performance of the audit process, which comes through the effective implementation of its tasks, where the auditor collects the necessary data about the nature of client activity, and any other information it deems necessary to carry out the planning and development of the strategy for how to determine the procedures for implementing the audit process and the scope and timing for evidence clues in order to form an opinion technician neutral about the fairness of the financial statements, as required by the standards of the field work of the planning and supervision of the internal control and evidence to prove, but the failure of the auditor whether in th

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Publication Date
Tue Mar 15 2022
Journal Name
Al-academy
The human self and its representations in the works of Salvador Dali
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The products of the surrealist school since its inception to this day have greatly influenced art in the world, so we find many artists around the world invested in their visual texts the forms generated by surrealism, and here the researcher raises several questions: What are the formal vocabulary that directly or indirectly refers to Self-used by the surrealist painter? Was the surrealist form understood as intended by the movement? In these questions, the research problem is summarized. The importance of it lies in identifying the references to the form of the human self, which are related to the psychological field in the works of the surrealists, especially Salvador Dali. Then the researcher chose his research community from the wor

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
The political image of Kurds and ideological representation in the Arab novel in Iraq
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The novels that we have addressed in the research, Including those with the ideological and political ideology, It's carry a negative image for the Kurds without any attempt to understand, empathy and the separation between politics and the people, The novels were deformation of the image, Like tongue of the former authority which speaks their ideas, Such as (Freedom heads bagged, Happy sorrows Tuesdays for Jassim Alrassif, and Under the dogs skies for Salah Salah). The rest of novels (Life is a moment for Salam Ibrahim, The country night for Jassim Halawi, The rib for Hameed Aleqabi). These are novels contained a scene carries a negative image among many other social images, some positive, and can be described as neutral novels. We can

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Publication Date
Wed May 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
The Social Dimension and Its Role in the Applicability of Smart Cities in Iraq
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Abstract<p>Smart cities are using innovative technological solutions to improve the quality of life and service that citizens and visitors receive. Defined as a digital or ecological city, its services depend on information and communication technology infrastructure, such as intelligent automated traffic systems, advanced security management Services, building systems, and the use of automation in offices and homes. The global trend now towards smart cities, sustainable and green cities and other cities, with different nomenclature, the common denominator is the comfort of the individual and the preservation of natural resources. Adopting smart, sustainable, green, or healthy cities is either t</p> ... Show More
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Publication Date
Tue Jul 20 2021
Journal Name
Materials Science Forum
Red Laser Irradiation Effect on the Structural Properties of MawsoniteCu&lt;sub&gt;6&lt;/sub&gt;Fe&lt;sub&gt;2&lt;/sub&gt;SnS&lt;sub&gt;8&lt;/sub&gt; [CFTS] Thin Films Deposited via Semi-Computerized Spray Pyrolysis Technique
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The existing investigation explains the consequence of irradiation of violet laser on the structure properties of MawsoniteCu6Fe2SnS8 [CFTS] thin films. The film was equipped by the utilization of semi-computerized spray pyrolysis technique (SCSPT), it is the first time that this technique is used in the preparation and irradiation using a laser. when the received films were processed by continuous red laser (700 nm) with power (>1000mW) for different laser irradiation time using different number of times a laser scan (0, 6, 9, 12, 15 and 18 times) with total irradiation time (0,30,45,60,75,90 min) respectively at room temperature.. The XRD diffraction gave polycrysta

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
The effect of aqueous crude extract of ginger on the histology of corpus luteum and the concentration of hormones estrogen and progesterone in pregnant mice
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This study was designed to investigate the effect of aqueous extract of ginger Zingiber officinale Roscoe on the histology of corpus luteum and the concentration of the hormones progesterone and estrogen during the first trimester of pregnancy (0 - 7) days from fertilization. 30 pregnant mice were divided into five experimental groups: control group (administrated with distilled water), and four groups treated at doses (284, 568, 1136,1420 mg / kg), orally administrated , daily with (0.1 ml). Microscopic examination results have shown histopathological changes in corpus luteum included: Pyknosis in some nuclei of granulosa cells, Karyorrhexis, Karyolysis in some granulosa cells, and necrosis in corpus luteum, with additional significant dec

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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
The dramatic act and its transformations in the Iraqi theatrical show "Black Astronomy play as a sample"
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The subject of the act and its transformations in the presentation is of great importance at the level of study, analysis and interpretation, and through that the researcher adopted the following title (The Dramatic Act and Its Transformations in the Iraqi Theatrical Show). The play of Black Astronomy was chosen as a sample for analysis, and the aim of the research came in order to achieve a special knowledge of the extent of the transformation that occurred between the dramatic structure of the act and theatrical embodiment and its multiple elements of operation in the Iraqi theatrical shows. It was limited to the show of the Iraqi theater in the year (2020) and included the theoretical framework that accommodated three sections. As for

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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
The most prominent philosophical and rhetorical concepts in the perspective of philosophers and theologians
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     This research aims to clarify and define the most important philosophical and rhetorical concepts to which many philosophical and rhetorical issues refer، since they have an effective role in the diversity and difference of intellectual schools، which are indispensable in proving major dogmatic issues، such as the concept of (existence، being، essence، and authenticity). Existence or Essence in contrast to the consideration of the other concept)، because it is one of the complex concepts and common words that carry different connotations among thinkers.

   And from (the rule of judging something is a branch of its perception)، the researchers began to define these concepts، as evidence of the sincerity of perce

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